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True Preventive Care

In a previous blog, I introduced the idea that “preventive care” in healthplans is really a misnomer.  The services we’re led to believe are preventive in nature (because that’s what they’re referred to) are nearly all screening or diagnostic – they don’t prevent disease.  Of the following benefits typically covered under “preventive care”, only one (1) is truly preventive.  Can you identify it?

  1. Physical Exams,
  2. PSA Testing,
  3. Routine GYN Exams,
  4. Pap Smears,
  5. Mammograms,
  6. Well-Child Visits,
  7. Immunizations.

If you picked “immunizations”, you’re right.  All of the other services are instrumental in diagnosing diseases, but only an immunization will actually prevent one.  Don’t see the logic yet in that?  Well, I assure that getting an annual physical exam every year will not prevent disease.  Your physician may inform you that you’re “at risk” of developing a disease (let’s say hypertension) but the prevention of that disease will likely involve a lifestyle change.  In my view, there are five (5) primary activities that have been proven to prevent disease:

  1. Exercise,
  2. Nutrition (including supplementation and hydration),
  3. Rest and Relaxation,
  4. Immunizations, and
  5. Avoidance of negative behaviors and situations, such as:
    • Smoking,
    • Excessive or binge alcohol consumption,
    • Stress,
    • Risky sexual, physical, driving, etc. activities,
    • Dangerous environmental exposures (i.e. radon, asbestos, mold, sunburns).

So, chances are, if your doctor says you’re at risk of developing hypertension, he or she is going to advise you to at least exercise more and eat better before he pulls out the ubiquitous script pad and puts you on the path of living a medicated life.

With regard to the healthplan however, the disconnect is obvious: Even though disease prevention is more effective, less intrusive and less costly than the treatment of disease, in nearly all benefit plans today, immunizations are pretty much the extent of true preventive care.

How can we begin making an investment in true prevention?  And how much of an investment (maybe as a percentage of healthplan expenditures) do you feel is appropriate?

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